Legal Eagle Eye Newsletter for the Nursing Profession (6)6 Jun 98
Quick Summary: The court ruled restraining a patient without an order is misconduct justifying a nurses termination.
In general, misconduct is serious enough to justify termination when there is willful disregard of an employers interests or deliberate violation or disregard of standards of behavior which the employer has the right to expect of its employees, or carelessness or negligence of such a degree or recurrence as to manifest culpability, wrongful intent or evil design or to show an intentional and substantial disregard of the employer's interests or of the employees duties and obligations to the employer. DISTRICT COURT OF APPEAL OF FLORIDA, 1998.
When the eye doctors nurse brought the resident back to the nursing home after cataract surgery in the doctors office, she told the nurse on duty for the 3:00 p.m. to 11:30 p.m. shift at the nursing home that the eye doctor insisted the patch stay on the eye "no matter what."
The eye doctors nurse brought along a set of soft wrist restraints they had been using in the doctors office to keep the resident from removing the patch from her eye.
However, the nursing home had a policy against restraints. The nursing homes procedures required restraints to be cleared with the nursing homes in-house physician before being applied to a resident. The nurse on duty knew this.
She left a phone message for the in-house physician, but after the resident took the patch off her eye she went ahead and applied the restraints before she actually received approval from the physician.
The next morning the director of nursing found the resident was still tied up in the restraints, and her hands had become red and swollen. The nurse who had applied the restraints was terminated the next day. The District Court of Appeal of Florida ruled there were sufficient grounds for her termination.
The court was not swayed because the in-house physician later backed up the nurse by saying he would have ordered soft restraints under the circumstances. The court ruled it was reasonable for the nursing home to have a policy against restraints and to enforce that policy with an airtight rule against a nurse applying restraints without prior approval from the in-house physician, upon pain of dismissal.
This nurse had previously been disciplined for other instances of substandard care. Giordani v. Unemployment Appeals Commission, 706 So. 2d 897 (Fla. App., 1998).